Public epistemic trustworthiness and the integration of patients in psychiatric classification

TY - JOUR

T1 - Public epistemic trustworthiness and the integration of patients in psychiatric classification

AU - Bueter, Anke

PY - 2021/8

Y1 - 2021/8

N2 - Psychiatric classification, as exemplified by the Diagnostic and Statistical Manual of Mental Disorders (DSM), is dealing with a lack of trust and credibility—in the scientific, but also in the public realm. Regarding the latter in particular, one possible remedial measure for this crisis in trust lies in an increased integration of patients into the DSM revision process. The DSM, as a manual for clinical practice, is forced to make decisions that exceed available data and involve value-judgments. Regarding such decisions, public epistemic trustworthiness requires (1) that these value-judgments should be representative of those of the affected public, and (2) that the public has a reason to believe such a representation to be realized. Due to the long tradition of (public) distrust in psychiatry, such a reason can in this case best be provided by an actual integration of patients into the decision-making process, rather than by their representation through scientific experts.

AB - Psychiatric classification, as exemplified by the Diagnostic and Statistical Manual of Mental Disorders (DSM), is dealing with a lack of trust and credibility—in the scientific, but also in the public realm. Regarding the latter in particular, one possible remedial measure for this crisis in trust lies in an increased integration of patients into the DSM revision process. The DSM, as a manual for clinical practice, is forced to make decisions that exceed available data and involve value-judgments. Regarding such decisions, public epistemic trustworthiness requires (1) that these value-judgments should be representative of those of the affected public, and (2) that the public has a reason to believe such a representation to be realized. Due to the long tradition of (public) distrust in psychiatry, such a reason can in this case best be provided by an actual integration of patients into the decision-making process, rather than by their representation through scientific experts.

KW - DSM-5

KW - Epistemic trustworthiness

KW - Lay participation

KW - Procedural objectivity

KW - Public trust

KW - Values in psychiatric classification

U2 - 10.1007/s11229-018-01913-z

DO - 10.1007/s11229-018-01913-z

M3 - Journal article

SN - 0039-7857

VL - 198

SP - 4711

EP - 4729

JO - Synthese

JF - Synthese

ER -